Efficacy and safety of mycophenolate mofetil treatment in active moderate to severe corticosteroid-resistant thyroid associated ophthalmopathy
10.3760/cma.j.cn311282-20201208-00813
- VernacularTitle:霉酚酸酯治疗糖皮质激素抵抗性活动性中重度甲状腺相关性眼病的疗效与安全性
- Author:
Xiaozhen YE
1
;
Shanshan HUANG
;
Jun LIU
;
Bin LU
;
Jiaqing SHAO
Author Information
1. 解放军东部战区总医院内分泌科，南京 210002
- Keywords:
Thyroid associated ophthalmopathy;
Mycophenolate mofetil;
Corticosteroid-resistant;
Immunotherapy
- From:
Chinese Journal of Endocrinology and Metabolism
2021;37(8):723-727
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of mycophenolate mofetil(MMF) in patients with active moderate to severe thyroid associated ophthalmopathy(TAO) refractory to multiple intravenous glucocorticoid(GC).Methods:Fifty-two patients with active moderate to severe TAO that was refractory to multiple intravenous GC were treated with MMF 0.5g orally, 2/d. To evaluate the overall response rate of TAO patients, the improvement of more than 3 items including clinical disease activity score(CAS), soft tissue involvement, proptosis, diplopia, decrease of eye movements, visual acuity and other improvements were defined as response.Results:After 12 weeks of MMF treatment, the overall response rate of TAO patients was 75.0%, and then increased to 88.5% significantly at the 24th weeks. At the 12th weeks, CAS decreased from(5.06±1.21) to(2.52±1.13), and then continued to decrease to(2.02±0.92) at the 24th week( P<0.05), the response rates were 82.7% and 90.4%, respectively. In addition, after 12 weeks of treatment, 58.1% of patients with diplopia improved significantly, and the response rate was 74.2% at the 24th weeks. Similarly, the degree of proptosis decreased significantly at the 12th and 24th weeks, and the response rates were 53.8% and 69.2%, respectively. No serious adverse events occurred during the treatment. Conclusion:The MMF therapy is efficient and safe for patients with active moderate to severe corticosteroid-resistant TAO.
